Thank You for Choosing JC Propane

Account Information

Please tell us a little about yourself and your billing address. Note: If you are a renter we must have permission from your landlord before setting up your account.

Bill To First Name

* Bill To Last Name/Company Name

* Billing Address

Billing Address Line 2

* City

* State

* ZIP

* Main Phone Number

Other Phone Number

Fax Number

* E-mail

Check here if you are a renter

We must have your landlord's permission to set up an account and your landlord must also have or set up an account for us to attach your account to.

Please provide us with your Landlord's Name

Landlord's Address

Landlord's Address Line 2

Landlord's City

Landlord's State

Landlord's Zip

Landlord's Phone Number(s)

Landlord's E-mail

Would you like to sign up for paperless billing?

Yes, sign me up!No, send my invoices to the address above.

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Tank Information

Where are we going? Please give us some information as to the physical location.

Click here if the physical address is different then your billing address.

Delivery Address

Delivery Address Line 2

City

State

ZIP

Directions (If applicable)

Is this a ...
New ConstructionSwitch tank from another companyI own my own tankOther (Please describe)

Desired tank size

Above Ground (AG)

Below Ground (UG)*

*Note: We do not sell or rent UG tanks. We do however you can purchase a tank from Mountain State Tanks of Fruita, CO (970)270-5927. We will transport the purchaced tank within our teritory for free as long as you use us as your service provider. Labor and parts will apply once we are on site.

*Note: We do not sell or rent UG tanks. We do however you can purchase a tank from Mountain State Tanks of Fruita, CO (970)270-5927. We will transport the purchaced tank within our teritory for free as long as you use us as your service provider. Labor and parts will apply once we are on site.

Company your switching from?Percentage in tank

Tank size

Above Ground (AG)

Below Ground (UG)

Percentage in tank

Please tell us a little about all the appliances that run on LPG (or will be running on LPG) (Please check all that apply.)

Furnace

Boiler

Boiler with Side Arm

Free Standing Heater

Fireplace Insert

Water Heater

Cook Range

Cook Top

BBQ Grill

RV

Other(s)

Furnace

Boiler

Boiler with Side Arm

Free Standing Heater

Fireplace Insert

Water Heater

Cook Range

Cook Top

BBQ Grill

RV

Other(s)

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Thank you

That's everything we need to set up your account. Please allow 24-48 hours for us to process your request.